[Isolated systolic hypertension as risk factor. Also in this case lowering blood pressure makes sense]

Abstract

Elevated diastolic as well as elevated systolic blood pressure substantially contributes to the increase of cardiovascular risk. Conclusive results have proven that lowering diastolic and/or systolic blood pressure can reduce cardiovascular risk. There is evidence that not only the absolute values for diastolic and systolic blood pressure alone but also the pulse pressure as an additional indicator of cardiovascular risk have to be considered. The prevalence of isolated systolic hypertension increases with age. Remodeling of the arterial wall with increase of collagen and decrease of elastic fibers are leading to an impaired compliance. Decreased compliance and acceleration of the pulse wave velocity can elevate systolic and lower diastolic blood pressure. Cardiac stress and pulse pressure in consequence will rise. In elderly patients there is a strong correlation between cardiovascular mortality and morbidity and systolic blood pressure. Antihypertensive therapy is able to lower cardiovascular morbidity and mortality in elderly patients with isolated systolic hypertension with a predominant risk reduction for stroke.